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Surgery seeks to restore function, improve cosmetic appearance, and enable use of standard footwear. This case report details successful management of a severe bilateral cleft foot using a diamond-shaped incision, cannulated screw fixation to narrow the forefoot, and correction of associated deformities. At one year, the patient achieved pain-free ambulation, off-the-shelf footwear compatibility, and satisfactory aesthetics.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/surgical-correction-of-a-severe-bilateral-cleft-foot-using-a-diamond-incision-and-cannulated-screw-fixation-a-case-report-and-literature-review/438312/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/surgical-correction-of-a-severe-bilateral-cleft-foot-using-a-diamond-incision-and-cannulated-screw-fixation-a-case-report-and-literature-review/438312.png","ImageObject",300,407,{"name":92,"@type":93},"hdkawk","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":8},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is cleft foot, and why is it clinically challenging?","Question",{"text":112,"@type":113},"Cleft foot is a rare congenital anomaly characterized by deficiency of the central rays of the foot, often bilateral and associated with other congenital findings. Its severity varies widely, making standardized treatment difficult and requiring individualized planning.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the severe bilateral cleft foot corrected in this case report?",{"text":117,"@type":113},"The report describes a diamond-shaped incision for cleft closure, cannulated screw fixation to narrow the forefoot, and correction of associated deformities.",{"name":119,"@type":110,"acceptedAnswer":120},"What outcomes were reported after one-year follow-up?",{"text":121,"@type":113},"At one year, the patient demonstrated pain-free ambulation, ability to wear standard off-the-shelf footwear, and satisfactory aesthetic results.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},438312,1790739682,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":8,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},3985747859855,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Review began 10/31/2025  \nReview ended 12/03/2025  \nPublished 12/06/2025  \n© Copyright 2025  \nAlzein et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98577  \nOpen Access Case Report  \nSurgical Correction of a Severe Bilateral Cleft Foot Using a Diamond Incision and Cannulated Screw Fixation: A Case Report and Literature Review  \nHassan H. Alzein 1, Hadi Mouslem 1, Ahmad A. El Lakis 2 , Ahmad Zahwi 1, Youssef Daher 1  \n1. Department of Orthopaedics and Traumatology, Lebanese University Faculty of Medicine, Beirut, LBN 2. Department of Internal Medicine, American University of Beirut, Beirut, LBN  \nCorresponding author: Hassan H. Alzein, [alzeinhassan94@hotmail.com](alzeinhassan94@hotmail.com)  \nAbstract  \nCleft foot is a rare congenital deformity, characterized by the absence of one or more central rays of the foot and presenting with a wide spectrum of clinical and anatomical variations. Surgical intervention aims to improve this deformity on three levels: functional rehabilitation, cosmetic appearance, and the ability to wear standard footwear.  \nThis case report describes the successful surgical management of a severe bilateral cleft foot (Blauth and Borisch Type III and Abraham Type II) . The technique involved a diamond-shaped incision for cleft closure, cannulated screw fixation to narrow the forefoot, and correction of associated deformities. At one-year follow-up, the patient demonstrated pain-free ambulation, the ability to wear off-the-shelf standard footwear like peers, and satisfactory aesthetic results. This report highlights the importance of tailored surgical planning in managing the diverse variants of cleft foot and contributes to the growing literature by presenting a new, modified technique addressing its reconstructive challenges.  \nCategories: Plastic Surgery, Pediatric Surgery, Orthopedics  \nKeywords: cleft foot syndrome, developmental pediatrics, foot surgery techniques, pediatric case, surgical skills day  \nIntroduction  \nCleft foot, also referred to as split foot, ectrodactyly, or “lobster claw,” is a rare congenital anomaly characterized by the deficiency of the central rays of the foot, corresponding to the second, third, and fourth metatarsals and their phalanges [1,2] . The severity of this deficiency can vary from partial shortening to the complete absence of these structures [2] . The cleft typically affects structures along the midline, usually  \nbeginning at the second or third ray and extending both longitudinally (from distal to proximal) and  \ntransversely (from tibial to fibular side) . As a result, the defect is always more pronounced distally and generally spares the first and fifth metatarsals [1,3] . This condition is often bilateral and frequently occurs as part of a syndrome in association with other congenital anomalies, such as syndactyly [2,4] .  \nThe underlying cause of cleft foot is attributed to inadequate activity of the medial apical ectodermal ridge (AER), a key signaling center in limb bud development. This deficit leads to decreased cell proliferation and abnormal foot morphogenesis. This condition is most commonly inherited in an autosomal dominant  \npattern, with reduced penetrance, although autosomal recessive, X-linked, and even sporadic cases have  \nalso been reported. Cleft foot was first reported in South Africa in 1770, and the current prevalence is  \nestimated by some authors to be approximately one in a million live births [4] .  \nGiven its rarity, no standardized treatment guidelines currently exist, and surgical management is typically individualized. Most reported cases have utilized techniques adapted from hand surgery with the primary goals of improving footwear compatibility, facilitating normal gait, and enhancing cosmetic appearan","cbCairVmI6C8Ma5E","https://ap.wps.com/l/cbCairVmI6C8Ma5E","pdf",2303613,"English","# Introduction\n# Case Presentation\n# Surgical Technique\n# Outcomes and Follow-up\n# Discussion\n# Conclusion","[{\"question\":\"What is cleft foot, and why is it clinically challenging?\",\"answer\":\"Cleft foot is a rare congenital anomaly characterized by deficiency of the central rays of the foot, often bilateral and associated with other congenital findings. Its severity varies widely, making standardized treatment difficult and requiring individualized planning.\"},{\"question\":\"How was the severe bilateral cleft foot corrected in this case report?\",\"answer\":\"The report describes a diamond-shaped incision for cleft closure, cannulated screw fixation to narrow the forefoot, and correction of associated deformities.\"},{\"question\":\"What outcomes were reported after one-year follow-up?\",\"answer\":\"At one year, the patient demonstrated pain-free ambulation, ability to wear standard off-the-shelf footwear, and satisfactory aesthetic results.\"}]","Surgical Correction of a Severe Bilateral Cleft Foot Using a Diamond Incision and Cannulated Screw Fixation - A Case Report and Literature Review | PDF",1790684977,15]